NPIMap

Organization Active NPI

Palmetto Health - University of South Carolina Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Columbia, SC
National Provider Identifier
1417445198
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP
Practice address
3010 Farrow Rd Ste 300
Columbia, SC 29203-7606
Phone
(803) 434-1210
Fax
(803) 434-1212
NPI assigned
Apr 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William D. Anderson III,, MD
Title
Chief Medical Officer
Phone
(803) 545-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X SC Primary

Addresses

Primary practice location

3010 Farrow Rd Ste 300
Columbia, SC 29203-7606

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

100 PH Parkway
Suite G-100
Columbia, SC 29212
Phone (803) 907-7800

Other identifiers 1

IdentifierTypeStateIssuer
GP7530MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Health - University of South Carolina Medical Group72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1417445198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 FARROW RD STE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292037606",
            "telephone_number": "803-434-1210",
            "fax_number": "803-434-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 PH Parkway",
            "address_2": "Suite G-100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29212",
            "country_code": "US",
            "telephone_number": "803-907-7800",
            "fax_number": "803-907-7809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "ANDERSON III,",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "803-545-5005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7530",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.